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Elective Stories
No full textFor my senior elective, I wanted to go abroad and experience medicine in a completely different setting than the UK. As I am interested in orthopaedics, this led to me applying for an elective at the University of Stellenbosch in South Africa. I had heard wonderful things from previous SSC and Elective supervisors about the fantastic experience in South Africa, after a bit of research I decided that Tygerberg Hospital in Cape Town seemed like the ideal destination.
I also had other more personal motivations for pursuing an elective in South Africa, as Cape Town holds a very special place in my own family history. During the Second World War, my Great-Grandfather was posted to Cape Town with the Fleet Air Arm as an aircraft engineer. Here, he met and married my Great-Grandmother, originally from Muizenberg (A beachside town to the south of Cape Town). Before my trip I was able to do extensive ancestral research and was able to visit some of the areas where she grew up and lived, allowing me to experience the culture she left behind in 1944.
Entering Tygerberg Hospital for the first time was very daunting. The hospital campus is the size of a small village and is the second largest hospital in South Africa - with 1899 beds. I was welcomed to the department with the 7:30 trauma meeting, where all the orthopaedic trauma patients admitted in the last day were discussed, and a surgical plan was formed for each.
The 24hr emergency theatre list from the day and night before was also discussed, with the registrars presenting each case to the team of consultants. After this I would head to theatres, finding a different list to scrub in with every day.
I was also able to shadow one of the registrars during their 24hr call shifts. Due to the high volume of trauma presenting to the hospital, there is an emergency orthopaedic theatre that runs 24/7, where surgeons can work through the backlog of trauma built up from the previous day. Outwith the hospital I had time to explore Cape Town as a city. Cape Town is a beautiful city with a vibrant cultural scene. There are regular tours to Robbin Island, a poignant activity that I feel is crucial in understanding the Apartheid era and inequality faced by so many South African Citizens. I would also thoroughly recommend a walk down Kloof Street, and a venture on the Table Mountain Cable Car, as well as surfing on Muizenberg Beach. Also, a trip to Cape Town is not complete without visiting the African penguin colony on Boulders Beach! The Western Cape is famous for its winemaking, and there were plenty of opportunities to explore the beautiful vineyards on the Franschhoek Wine Tram.
Tail Lights
No full textHappy New Year! Hopefully, everyone had a restful festive break and is settling into the rhythm of the Glasgow Medical School routine. With the Academic year in its second term, it has been wonderful to meet you at teaching and in the hospitals.
As you progress through your studies in medical school and life as a doctor – you may occasionally wonder “Is this it?” I grapple with this question regularly. Don’t get me wrong – I have wanted to be a doctor for as long as I remember and am so grateful for that opportunity. I possess all the ingredients to ensure happiness - but why can’t I shake that feeling of “something’s missing”.
Thank you to everyone who came to visit the “Navigating Uncertainty” exhibition at the Clarice Pears last term. We were blown away by the response, especially the support from Professor Sir Kenneth Calman! If you missed it, the digital art collection can be viewed here: https://medicineandtheartsglasgow.com/ - QR code below.
Big thank you to Julianna Sandoval Alfonso, Charlotte Duffus, Rueben Heaton, Laura Hewitt, Tazra Khan, Gregor McIntosh, and Grace So for your help filming the Active Bystander videos – you were all big hits in Liverpool as part of a collaborative project on medical student Active Bystander Training!
We are busy planning new initiatives for you through MedChir and Surgo – so keep an eye out for these over the next few weeks.
Seems I am not alone. In his “final prescription for the nation” last week, Dr Vivek Murthy summarises his observations after 2 terms as Surgeon General of America. Seems self-worth and fulfillment needs 3 ingredients: Purpose, Service, and Relationship. Remember when we did sports, volunteered in community service before medical school? Turns out all that is actually good for us! (Not just for the CV...). I encourage you to read this short piece – and come back to it often – I promise it will be more than worth your time. QR code below and link here: https://www.hhs.gov/sites/default/files/my-parting-prescription-for-america.pdf
Meantime - keep your submissions coming for the Visual Abstract and Surgo Vision competitions Remember: 5 best submissions accepted for publication receive £20 with a chance to win the end of year £100 overall best submission prize – and is legitimate CV fodder! So get your skates on and showcase your work with the world!
Till the next Tail Lights – I wish you much fulfillment! Remember: you are the OG! You have worked hard to get into one of the best medical schools in the world and you are well on your way to becoming doctors. That’s purpose and service checked: go work on your relationships
Medical Uncertainty Guided By The Arts
No full textThe high level of assuredness expected of doctors in making life-altering decisions for their patients is juxtaposed with the inherent uncertainty in medicine. Medics must learn to navigate this uncertainty when faced with the everyday trials of balancing resource limitations, diagnostic uncertainty, ethical and social complexity, and multi-morbidity.
When confronting uncertainty in medicine, even at the rudimentary stage of a medical student, there is implicit understanding that we are opening ourselves up to the increased risk of making errors that could have lasting impact on our patients.
With this in mind, I was intrigued, and somewhat sceptical, when presented with the opportunity to undertake an elective in medical humanities, exploring how clinical uncertainty can be managed through the arts and wider humanities. Throughout the four-week elective, there was exposure to an array of disciplines including theatre, music, photography, ethics, and politics.
Among the many experts sharing knowledge of their respective fields was Professor Strazzacappa, who facilitated a week-long workshop of Medical Education Empowered by Theatre (MEET), which serves as a compulsory component of the medical curriculum at the University of Campinas in São Paulo, Brazil1.
The concept of MEET is founded on Boal’s Theatre of the Oppressed and Freire’s Critical Pedagogy1.These ideologies have been amalgamated to foster a learning environment of mutual respect that allows medical students to reflect upon, action change and resolve complex social scenes, often rooted in uncertainty, within the safe space of theatre1. Planning such scenes and improvising the performance in front of an audience, with no previous drama background, was both challenging and oftentimes uncomfortable. Feeling exposed, and subject to the analysis of others while performing incited vulnerability, not dissimilar to that experienced by patients who are also submitted to watchful observation in unfamiliar environments.
Aside from allowing us to better empathise with our patients, the self-directed nature of theatre improvisation required ongoing reflection and cognisance of how performance and communication can be attuned to meet the demands of complex, evolving situations and dialogue1. By employing the theatre-instilled practices of improvisation, awareness of stage presence and continuous self-assessment, we found ourselves more equipped to react and adapt to the fast-paced unpredictability of clinical practice, and action a collective approach to managing medical uncertainty1.
The elective was also useful in identifying a widespread variance in the interpretations of art amongst a group of medics. This disparity in opinions prompted healthy debate, receptivity to others’ perspectives and ultimately, reluctant recognition that art’s subjective nature means no one individual’s interpretation can be ‘correct,’ but rather shaped by our own individual experiences. Embracing this subjectivity allowed us to acknowledge that medical complexity cannot always be met with linear strategy or a definitive solution, and that accepting this is a step towards resolution in itself.
Art harbours hidden depth in that it relays meaning beyond words. As such, it can prove challenging to interpret what message the artist intends to convey. Navigating this uncertainty draws upon lateral thinking, introspection and consideration of how individual elements come together to evoke a response from the observer. The application of this reflective process to medical contexts aids in the holistic interpretation of a patient’s overall clinical picture where the initial presentation is multi-faceted, and the diagnosis is unclear.
While the underpinning of medicine follows an objective, evidence-based approach, the fundamental “human” core is where its innate subjectivity lies. Both patients and doctors are real people, whose unique experiences shape their perceptions, interactions, decisions and expectations of clinical care. These positions do not always align, and as such, an appreciation of the arts allows us to work alongside this subjectivity, rather than focus on the variables we cannot control.
While the arts cannot eliminate the inherent uncertainty in medicine, nor diminish the cruciality that sound textbook knowledge and clinical competence hold, insight into their subjectivity and an awareness of the parallels within medicine allows for acceptance and reconciliation of the everyday variables and uncertainty doctors must negotiate.
Overall, the elective showcased that the dichotomy between art and science is bridged in medicine. When the lessons of each are applied to clinical contexts, the pair form a mutualistic relationship in which the subjectivity of the arts coupled with the objectivity of science serve as a medical gateway to balanced decision making, well-informed professional reflection and therapeutic patient interactions.
Widespread integration of arts-based learning within existing medical curricula could take form by means of similar modalities to MEET, exploration of anatomy and clinical presentations through illustrative work, or reflecting on medical encounters via creative outlets such as writing or drawing. Widening the modalities through which medical education is delivered could augment critical thinking and affirm a sense of professional identity among students, ultimately facilitating a rise in doctors armoured with the framework to capably navigate a future career of uncertainty in medicine. No AI was used in writing this article.
Reference:
1. de Carvalho Filho MA, Ledubino A, Frutuoso L, da Silva Wanderlei J, Jaarsma D, Helmich E, Strazzacappa M. Medical Education Empowered by Theater (MEET). Acad Med. 2020 Aug;95(8):1191-1200. doi: 10.1097/ACM.0000000000003271. PMID: 32134785
Distal Clavicle Fractures
No full textInvestigating the clinical outcomes of distal clavicle fractures managed in NHS Greater Glasgow and Clyde
Editorial
Full text linkIt is fitting that the launch of Business and Industrial History, which started out as Scottish Industrial History (1977-2010) and then continued as Scottish Business and Industrial History (2011-23), as an open access platform, should have as its subject one of Scotland’s most enduring and both materially and symbolically significant industries; that of Scotch whisky. 
Scotland’s Oldest? Some Examples of the Use and Misuse of Archives in the Writing of Scotch Whisky History
Full text linkThis article explores examples where the information contained in corporate and other archive collections is open to misinterpretation and they ways in which it can be misleading when presented out of historical context. 
The Impact and Consequences of the Excise Act 1823 on Distilling in Ireland
Full text linkThis paper considers the impact of the Excise Act 1823 on the development of the Irish whiskey industry. A feature of early nineteenth century Ireland, and to a lesser extent Scotland, was the high incidence of illicit distilling. The Act aimed at encouraging compliance amongst these ‘men of little capital’ and instead set up small distilleries. In doing this it incorporated the existing regime for still licensing in Scotland and the recently introduced duty free storage in Crown warehouses already in Ireland. This resulted in the transformation of the industry in both Ireland and Scotland. Ultimately the industry was more successful in Scotland than in Ireland and the divergent paths followed over the nineteenth and early twentieth centuries are discussed
Letters Inherited
Full text linkJessica McKendrick is a postgraduate MSc Science Communications student at the University of Glasgow, with a foundation in Human Biology. Her literary interests, specifically poetry and prose, have led her to consider the intersect of creative writing as a means of scientific communications. Her work draws inspiration from lyrical prose to craft evocative imagery and emotional textures of complex medical realities; shaping creative narratives that deepen public understanding and empathy
Laudatio Turiae
Full text linkThis piece is based on the Laudatio Turiae, a tombstone inscription from classical Rome from a husband to his wife. This short piece tells the wife\u27s story when she is distraught that it seems she cannot bear children for her husband, and seeks out Rome\u27s physicians, eventually leading her to the Greek physician, Asclepiades.
Learning for All: Exploring the Relationship Between Inclusion and Achievement in a Primary Setting
Full text linkAll education practitioners have a responsibility to support the participation and achievement of all children within learning communities – particularly within increasingly diverse societies. Inclusive pedagogy allows an exploration of what education practitioners believe, know and do, alongside the research literature on inclusive approaches to teaching, to support this participation and achievement. By utilising the Framework for Participation (Florian et al., 2017), this research aims to understand how the concepts of inclusion and achievement are constructed within a local primary school recognised as being inclusive of its diverse population. This single-site case study incorporated multiple methods of data collection, within an iterative process, and utilised deductive thematic analysis to draw key themes around what practitioners and the school community believe, know and do. The Framework for Participation allowed for an in-depth socio-cultural exploration of inclusion and achievement, including tensions and contradictions, which are highlighted. Ways in which this research methodology can complement and extend the reflective development of inclusive practices in schools are discussed